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Shawnee County residents at a loss with loss of home health program

Private agencies charge three to five times the cost

James Doty, 74, is confined to his chair and relies on Shawnee County home health aides to give him baths twice a week - a service for which he pays $10 because of his low income. The service ends Dec. 13, forcing Doty to consider paying three to seven times that amount for a private agency. His daughter, Tammy Doty, at left, condemned the Shawnee County Commission on Monday for their approval of the program's closure.

About a year ago, James Doty laughed when he heard a story about a man who couldn’t drive because he was too fat to fit under the steering wheel.

Today, Doty, 74, hasn’t driven in eight months — for the same reason.

In part because of the progression of both Parkinson’s disease and diabetes, Doty has grown to 323 pounds. He is confined to a grayish-brown chair that faces a small television in his Oakland home, and he requires assistance to so much as scratch his back.

“I can’t wash myself,” he said. “Taking a shower is one of the main parts of living.”

Since this summer, Doty has relied on a home health aide with the Shawnee County Health Agency to bathe him twice a week. His limited income — Social Security and a few hundred dollars per month in retirement — means he only has to pay $10 a week.

But come Dec. 13 — the day Doty turns 75 — the county’s home health program will come to a close, yet another victim of next year’s budget cuts. When that happens, 61 Shawnee County residents who relied on the discounted service for bathing, cleaning and shopping will be forced to find alternatives.

With private home health services costing between three and seven times that amount and the only other option offered being a nursing home, Doty and his family are at a loss.

“That’s the last place I want to go,” James Doty said of the nursing home.

“We don’t have a plan, and it ends in two weeks,” said his daughter, Tammy Doty. “It’s just scary.”

Layoffs

Tammy Doty, in town from Sacramento, Calif., to help care for her disabled parents while her sister recovers from a recent stroke, spoke before the Shawnee County Commission on Monday. She condemned them for their short-sightedness and abandoning one of the community’s most vulnerable populations.

“It’s just baths,” she said. “It’s a very simple thing, but it has become a tremendous thing for our family. I don’t know whether you all understand when you made this vote the impact it will have on people’s lives.”

At times fighting back tears, Doty relayed how her father relied on the service, how he couldn’t afford the high prices of private agencies, how the decision to close the program disgusted her. As a native Topekan, Doty later said, she was “embarrassed to call this community home.”

The commission on Nov. 7 approved a recommendation from staff that laid off 15 employees, cut 20 vacant positions with the parks and recreation department, and reclassified three jobs. The move was expected to save $1.4 million, though it could cost about $40,000 for severance packages.

Six of those employees came from the Shawnee County Health Agency — the five aides and a registered nurse affiliated with the home health program. Their jobs will end Dec. 13, but the agency is working with each of them to see if another position is available within the county, said Allison Alejos, director of the local health department.

Total, the health positions will save the county about $200,000 — the five health aides had a total compensation of $149,000, and the average registered nurse made about $50,000, according to Shawnee County records from 2012.

That represents 0.3 of a percent of the county’s $75 million budget.

The agency made the decision to close the home health program based on a number of factors, including the $494,939 budget cut and lower revenues from the program.

“While there were other cuts made to accommodate these changes, this cut had the most significant impact,” said spokeswoman Misty Kruger.

But, Tammy Doty said, forcing those people to seek help elsewhere, help they can’t afford on their own, only will increase costs.

“I just think it’s so short-sighted,” she said. “Maybe your budget gets shifted a little, but the cost to society is far greater.”

Commissioner Shelly Buhler was the lone vote against the cuts, indicating the county could have pursued early retirement and other incentives to avoid the cuts. She offered Doty her condolences, adding that the decisions aren’t made lightly.

Cost differences

Alejos couldn’t share any names of those patients receiving home health services, but at least one other person has spoken up about the issue.

Betty Fanckboner, 89, made a point to come all the way from her Auburn apartment to the county commission meeting the day it voted on the cuts. From her chair, she enumerated how a home health aide comes for two hours Friday afternoons to help Fanckboner with grocery shopping and cleaning.

As of Monday, Fanckboner indicated her aide, whom she affectionately calls by first name, will continue helping her on her own, for just $2 more per week.

Of the home health patients, 16 already receive benefits from the Jayhawk Area Agency on Aging. Several others were using the county service for light housecleaning, meaning they have multiple options, she said.

That leaves about 10 people who were counting on the county’s home health services for bathing, Alejos said.

“It’s a small number, but those services mean a lot to those families,” she said.

The county is working closely with those individuals to try to help them find another service, Alejos said. The major issue, she continued, is that the county offered a sliding fee scale based on income. Many of the other agencies don’t.

For individuals making at least $2,108 a month, the county charged $21 an hour. Those making $1,436 a month and lower received the service for no cost.

The health agency was able to offer the sliding fee scale because its larger budget and grants helped offset some of the costs.

The county health agency has been providing individuals with a list of nine private home health services in the county. Calling all of them wasn’t easy, Tammy Doty said, and wondered how those with no income or family would be able to handle the stress.

What she learned was even more disheartening. The private services would cost the Dotys an average of $276 a month for two baths a week, she said — nearly five times what they pay now.

Caregivers Home Health, 1129 S.W. Wanamaker, for example has a two-hour requirement and a flat $19 an hour rate — meaning, at minimum, the Dotys would pay $76 a week compared to $10 with the county.

Angels At Home Care has an hour minimum requirement at $17.50 an hour. At that rate, the Dotys would pay $35 a week.

Home Instead Senior Care declined to provide rates but noted it had a three-hour requirement for services. Doty’s baths usually take about 30 minutes.

The Dotys have dealt with private agencies, Tammy Doty said, and they can’t go back.

Before a social worker put them in touch with Shawnee County, they were paying a much higher rate for one bath a week — the agency had a two-hour minimum, and the Dotys nearly went into debt trying to afford that. Just one bath a week also resulted in serious health problems for her father, she said.

BY THE NUMBERS

The Shawnee County Health Agency will stop providing home health services after Dec. 12, forcing about 61 residents to seek help elsewhere. Below are a few cost comparisons of services offered by the program and private agencies: